MR. BRIAN BAHMAN BORG (NPI# 1902916778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902916778 |
| Entity Type | Individual |
| Full Name | MR. BRIAN BAHMAN BORG |
| Credential | MD, MHSC |
| Practice Address |
971 Lakeland Dr Ste 1159 Jackson MS 39216-4609 |
| Practice Telephone | 7692515674 |
| Practice Fax Number | 7692438130 |
| Mailing Telephone | 7692515674 |
| Mailing Fax Number | 7692438130 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | D 0059992 | MD | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
2006012188 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RI0008X |
Internal Medicine Specialization: Hepatology |
22079 | MS | Allopathic & Osteopathic Physicians |
| N | 207RI0008X |
Internal Medicine Specialization: Hepatology |
MD.202825 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02752313 | 05 | |
| LA | 1887056 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 North State Street, Jackson, MS 392164500 | 6018154775 | 6019846451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912113945 | Brian Borg | Dentist | 3626 W 5600 S, Ste D, Roy, UT 84067-9161 | 2007-05-15 |
| Street Address |
971 LAKELAND DR STE 1159 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669086096 | Aimee Cockerham | Nurse Practitioner | 971 Lakeland Dr Ste 1159, Jackson, MS 39216-4609 | 2020-09-02 |
| 1245754506 | Jackson Liver and Gi Specialists Inc. | Clinic/Center | 971 Lakeland Dr Ste 1159, Jackson, MS 39216-4609 | 2017-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207RI0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hepatology |
| The discipline of Hepatology encompasses the structure, function, and diseases of the liver and biliary tract. The American Board of Internal Medicine considers Hepatology part of the subspecialty of gastroenterology. Physicians who identify themselves as Hepatologists usually, but not always, have been trained in gastrointestinal programs. |
| Notes: Training Programs, and/or Fellowships, Preceptorships: The American Association for the Study of Liver Diseases (AASLD) is the major professional society organized for physicians with an interest in Hepatology. A subcommittee of that organization has published guidelines for training programs in the 1992 November issue of Hepatology. Source: The American Board of Internal Medicine 9/1993 ACGME Accredited Residency Program Requirements: None |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.